New and Old Criteria for Diagnosing Celiac Disease

Background: CD is an immune-mediated systemic disease elicited by gluten and related prolamines, it affects genetically susceptible individuals and it is characterized by the presence of gluten-dependent clinical manifestations, CD-specific antibodies, HLA-DQ2 or HLA-DQ8 haplotypes and enteropathy.

Aims: The aim of our study is to analyse two groups of patients: one in which diagnosis was based on the new ESPGHAN criteria, and another based on the 1991 Revised Criteria. Both are tested for average age of diagnosis, sex, presenting symptoms and comorbidities. The objective is to find relevant differences between the two groups.

Patients and Methods: Our study involves 25 patients having the CD onset from February 2013 to February 2019 with the following features: presence of anti-TTG IgA antibodies with a titer higher than at least 10 times the threshold value, presence of EMA IgA serology, compatible genetic profile (HLA-DQ2 and/or DQ8), clinical features. The values obtained were compared with those of 25 children with CD diagnosis performed through the 1991 Revised Criteria.

Results: In group 1 a prevalence of comorbidities such as IDDM and thyroiditis equal to 48% was found.

In group 2 there was a prevalence of comorbidities such as IDMM and thyroiditis equal to 20%.

A statistically significant difference emerged between the two groups of patients when we analyzed the incidence of autoimmuny comorbidities. The P value of χ ² test was indeed

Conclusion: An increased prevalence of overall comorbidities (IDDM and thyroiditis) in the first group shows that the new diagnostic criteria could expose patients to a greater diagnostic delay responsible for the onset of such comorbidities. Further studies should be carried out on more numerous samples to highlight possible statistically significant differences between the two groups.